AVR on Nov 21, 2022

[pellicle]

@Dunwanted for your amusement this is the basic blow on factor XII

https://en.wikipedia.org/wiki/Factor_XII
you can look up the others after you've read that (recommended reading if you can't sleep properly)

 

[70sdiver]

Man glad to hear your doing well!

 

[Dunwanted]

Hello guys again, I still haven't been discharged due to my heart going crazy yesterday it jumped to the 130s while I was in the bathroom. My rest heart rate for example right now in the morning is at 103.

Also I'm very scared because I started having sharp tooth pain when eating to brushing my teeth (only on one tooth on the right side) this started yesterday going to tell my cardiologist today about this.

 

[erricojj]

Hello guys again, I still haven't been discharged due to my heart going crazy yesterday it jumped to the 130s while I was in the bathroom. My rest heart rate for example right now in the morning is at 103.

Also I'm very scared because I started having sharp tooth pain when eating to brushing my teeth (only on one tooth on the right side) this started yesterday going to tell my cardiologist today about this.

I ran into dental problems about 4 weeks post op. See my Dental Work - A Saga for a painful amount of detail (or a detailed amount of pain). If it turns out that you need dental care now, antibiotics will protect you. However, look out for the GI side effects...they can be nasty.

Hope your cardiologist gets you some answers on the heart rate soon. Hang in.

 

[Dunwanted]

I ran into dental problems about 4 weeks post op. See my Dental Work - A Saga for a painful amount of detail. If it turns out that you need dental care now, antibiotics will protect you. However, look out for the GI side effects...they can be nasty.

Hope your cardiologist gets you some answers on the heart rate soon. Hang in.

Thanks for sharing, I spoke to the cardiologist I'm getting discharged today, I dis tell him about my tooth hurting he did not seem to worry at all he just said to get a dental cleaning at the dentist.

 

[LondonAndy]

I can't say anything useful about the dental problem, but just wanted to mention something that my doctor told me many years ago. I had a sudden onset of diabetes, and was initially diagnosed as a "type 1" - injecting insulin every day etc. Not long after, I was back in his office with another problem - I forget what. He wisely reminded me: just because you are now diabetic doesn't mean that every ailment will be caused by it". Not sure if that is relevant here, ie if the tooth pain is because of something cardiac related, but I thought it was good advice to pass on.

 

[Superman]

Hello guys again, I still haven't been discharged due to my heart going crazy yesterday it jumped to the 130s while I was in the bathroom. My rest heart rate for example right now in the morning is at 103.

Also I'm very scared because I started having sharp tooth pain when eating to brushing my teeth (only on one tooth on the right side) this started yesterday going to tell my cardiologist today about this.

I had severe tooth pain for a month after. Everything had to be room temp to maybe a little warm. Hot or cold hurt to eat/drink. I used sensodyne toothpaste during that time. I was told it was from my jaw clamping down on all the tubes shoved down my throat. Just that all day pressure on my teeth. Good news is I eventually recovered and still have all my teeth.

 

[Dunwanted]

Thanks @LondonAndy & @Superman, I suspect its a tooth I had repaired a few month a go, when I sleep I do grind my teeth and I think it's due to that, it hurts when it's hot or cold and when I bite on that aide, either way I will tell the cardiologist on Wednesday what to do as it is very annoying and hurts really bad when I drink or bite

 

[Superman]

Thanks @LondonAndy & @Superman, I suspect its a tooth I had repaired a few month a go, when I sleep I do grind my teeth and I think it's due to that, it hurts when it's hot or cold and when I bite on that aide, either way I will tell the cardiologist on Wednesday what to do as it is very annoying and hurts really bad when I drink or bite

Happy to help. Trust me, Sensodyne and room temp water are your friends right now. But I’m not a doctor.

 

[pellicle]

But I’m not a doctor.

Or a Dentist

 

[Dunwanted]

Yeah sending some one to buy it tomorrow morning, I did search tooth sensitivity and it describes exactly my symptoms and I really hope it's just that.

 

[ATHENS1964]

If you have a problem with teeth grinding during the night then tell the dentist to make you a
night guard.
https://www.stpetedentist.com/blog/5-reasons-wear-night-guard/
https://www.amazon.com/Oral-B-Nighttime-Dental-Scope-Professional/dp/B0170BHYGE

 

[Dunwanted]

Hello guys I'm a bit scared I went for a check up for my INR and the did not tell me anything and I took my dose (7.5) and just about 15 mins later they called me and told me to not take the dose because my INR was 3.5.

She just told me not take the dose, what should I do? Should I take any precautions or what should I do?

 

[LondonAndy]

Firstly, 3.5 is not exceptional. What is the therapeutic range they have set? Mine is 2.5 to 3.5, so 3.5 for me would be fine, and a bit over would not worry me either. When was your last test, and what was the result then? Speed of change is relevant.

Secondly, how did they check your INR? My Coaguchek XS is usually 0.1 or 0.2 higher results than when I test with a blood draw at a clinic (though blood draws are quite rare now - the CoaguCheck machines are perfectly accurate enough.

Thirdly I am always wary of big changes in dose. So for me I would have to be A LOT over my maximum to do skip a whole dose, and there is a danger of yo-yoing with big adjustments, making it take ages to get back on track. . Remembering that Warfarin takes about 3 days to take effect.

Finally, has anything else changed? Are you now on antibiotics, or do you have a cold? Both of these push my INR up.

So, questions summarised:

1. What is your therapeutic range?
2. when was your last test, and what was the result?
3. Do you have a cold?
4. Have you recently started antibiotics (or any other new medication)?
5. Is the weather there gorgeous today or not? (Hint: it's gorgeous compared with London right now ...)

 

[Dunwanted]

My range is 2.2 -3.0 something like that, my last check up was 3 days a go and it was 2.2, and today I had a check up and it was 3.5 and the doctor told to get it check again tomorrow and day after tomorrow and to stop taking my warafin, but today I did take it (rookie mistake, I should always wait for the doc to give me information before drinking the warafin).

Do not have a cold, weather is very cold but i haven't gone out due to the fact that my surgery was not long a go, I did notice some weird bruising on my arm.

 

[Dunwanted]

Ooh and I don't have a self check machine

 

[LondonAndy]

That is a rapid change, but don't panic. I would be interested to hear what others say, but I would say don't take tomorrow's dose. Consider eating some foods high in vitamin K with dinner, eg leafy green vegetables. You will bruise more easily, so continue to stay at home or at least not do anything that might cause impacts.

 

[Dunwanted]

That is a rapid change, but don't panic. I would be interested to hear what others say, but I would say don't take tomorrow's dose. Consider eating some foods high in vitamin K with dinner, eg leafy green vegetables. You will bruise more easily, so continue to stay at home or at least not do anything that might cause impacts.

Thank you, my doctor did not seem to worry much and basically said the same thing, I'm just worried since I'm 8 days out of surgery.

 

[LondonAndy]

You're welcome. Not sure if you have come across this graph that @pellicle often posts, to help understand INR risks. You will see 3.5 isn't generally a problem, though of course I should have said I am not a doctor and my comments have been based on my 8 years of taking Warfarin. Others have a lot more experience!

 

[Superman]

Personally I never hold a dose. I’ll go half at most. Maybe throw some spinach on something, or just knock a milligram off.

This is anecdotal and not encouraging you to start a debate with your clinic. But holding doses for me is what used to start a yo yo. Hold a dose, go below range. Clinic panics, tells you to take 10 mg’s. Back above range. Rinse, repeat, and they can’t figure out why it’s so hard to stabilize.

My prescribed range is also 2.5 - 3.5 so that wouldn’t even cause me to change anything. But that’s just me.

BTW, takes about three days for todays changes to show up in test results.

If a pot is about to boil over, do you turn the flame off, or just down a bit?